International Journal of Chronic Obstructive Pulmonary Disease最新文献

{"title":"The Association Between Glycemic Variability and In-Hospital Mortality in Patients with Chronic Obstructive Pulmonary Disease: A MIMIC-IV Database-Based Retrospective Cohort Study.","authors":"Jiajia He, Yuxin Chen, Qian Wang, Wenhai Yu, Yongsheng Zhang","doi":"10.2147/COPD.S561481","DOIUrl":"https://doi.org/10.2147/COPD.S561481","url":null,"abstract":"<p><strong>Purpose: </strong>The association between glycemic variability (GV) and the clinical outcomes of patients with chronic obstructive pulmonary disease (COPD) remains uncertain. This study aimed to assess the connection between GV and hospital mortality among hospitalized COPD patients.</p><p><strong>Patients and methods: </strong>Data from the MIMIC-IV database were used in this study. GV was analyzed as a continuous variable and in quartiles. Cox proportional hazards modeling with stepwise adjustment was used to assess the link between GV and in-hospital mortality, and HRs and 95% CIs were calculated. A restricted cubic spline model was applied to explore non-linear associations. Survival curves and Log rank tests were performed to assess survival differences. Subgroup analyses and interaction tests were conducted to determine the relationship across diverse populations.</p><p><strong>Results: </strong>Our analysis encompassed 11873 patients, among whom 838 individuals died during their hospitalization. A significant association between GV and in-hospital mortality in COPD patients was found across all Cox proportional hazards models: the unadjusted model (HR [95% CI]: 1.849 [1.409, 2.427], P < 0.001), the partially adjusted model (HR [95% CI]: 1.880 [1.432, 2.468], P < 0.001), and the fully adjusted model (HR [95% CI]: 1.551 [1.110, 2.167], P = 0.01). The restricted cubic spline (RCS) models revealed a significant non-linear relationship (P-nonlinear < 0.001). Survival curves demonstrated significant differences in in-hospital survival rates across varying GV levels (log-rank P < 0.0001).</p><p><strong>Conclusion: </strong>GV exhibited a strong association with in-hospital mortality among COPD patients, and significant differences were observed in in-hospital survival rates across varying GV levels.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"561481"},"PeriodicalIF":3.1,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13005190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147500386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Subsegmental Dosing Accuracy and Outcomes of Bronchoscopic Thermal Vapor Ablation: An Exploratory Retrospective Study in Severe Heterogeneous Emphysema.","authors":"Han Yang, Si Chen, Xiaoxuan Zheng, Ningxin Cui, Fangfang Xie, Huan Hou, Lin Ye, Felix J F Herth, Jiayuan Sun","doi":"10.2147/COPD.S560457","DOIUrl":"10.2147/COPD.S560457","url":null,"abstract":"<p><strong>Purpose: </strong>Bronchoscopic thermal vapor ablation (BTVA) is a minimally invasive treatment for severe emphysema. However, the treatment doses are typically generated at the segmental level. In specific cases, treatment needs to be conducted at the subsegmental level, and the proportion can only be roughly allocated based on CT image review, potentially leading to dose mismatch. This retrospective exploratory study investigated the relationship between subsegmental dose accuracy (theoretical-to-actual matching) and clinical outcomes following BTVA.</p><p><strong>Methods: </strong>Patients who underwent BTVA at the Shanghai Chest Hospital between 2023 and 2024 were analyzed. Subsegmental theoretical doses (BroncQCT software) were compared to previously administered actual treatment doses. Dose matching was defined as: 1) segmental treatments were presumed matched (uniform vapor assumption), 2) subsegmental treatments required ≤10% deviation between actual and theoretical dose ratios (|Actual ratio - Theoretical ratio| × 100%). Patients with >10% deviation or BroncQCT-identified nontarget subsegments were unmatched. Clinical parameters at 1, 3, 6, and 12 months after single treatment were compared.</p><p><strong>Results: </strong>Among 21 patients (15 matched, 6 unmatched), the mean changes in FEV₁ for the overall cohort were +70mL at 1 month (n = 19, <i>P</i> = 0.018), +90mL at 3 months (n = 14, <i>P</i> = 0.056), and +130mL at 6 months (n = 8, <i>P</i> = 0.015). The matched group demonstrated superior median increases compared to unmatched patients (+150mL [n = 9] vs +10mL [n = 5]; <i>P</i> = 0.012) at 3 months where between-group differences were maximal. Similar trends were observed at 1 month (median +110mL [n = 14] vs 0mL [n = 5]; <i>P</i> = 0.044) and 6 months (median +150mL [n = 5] vs +60mL [n = 3]; <i>P</i> = 0.036). Adverse events (including two late deaths in comorbid patients) were documented, though small sample sizes prevent definitive safety conclusions.</p><p><strong>Conclusion: </strong>This exploratory study found that subsegmental dose matching was associated with greater FEV₁ changes after BTVA. These hypothesis-generating findings require prospective validation in a randomized controlled trial (NCT06152107).</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"560457"},"PeriodicalIF":3.1,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13006177/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147516226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Difference in Respiratory Function Between GOLD Stage 1 and Preserved Ratio Impaired Spirometry as Assessed by Impulse Oscillometry and Spirometry.","authors":"Ayumi Shimizu, Mitsunori Hino, Kaoru Kubota, Akiko Yoshikawa, Koichiro Kamio, Yosuke Tanaka, Masahiro Seike","doi":"10.2147/COPD.S571172","DOIUrl":"10.2147/COPD.S571172","url":null,"abstract":"<p><strong>Purpose: </strong>Preserved ratio impaired spirometry (PRISm) is heterogeneous, and its physiological relationship to early COPD remains unclear. We compared respiratory-mechanical patterns between non-restrictive PRISm (NrP) and GOLD stage 1 COPD (GOLD 1) using impulse oscillometry (IOS) and spirometry and explored longitudinal changes in a trackable subset.</p><p><strong>Patients and methods: </strong>We retrospectively analyzed 1,139 adults who underwent post-bronchodilator spirometry in 2013; IOS was available for a subset. PRISm was defined by FEV₁/FVC ≥ LLN with %FEV₁ <80%. GOLD 1 was defined per GOLD criteria (FEV₁/FVC <0.70; %FEV₁ ≥80%). Longitudinal analyses were restricted to individuals with >10 pack-years, IgE <170 U/L, eosinophils <300/µL, and ≥2 examinations to minimize Th2-high asthma confounding.</p><p><strong>Results: </strong>Among PRISm cases, 18 met NrP criteria, and 127 met GOLD 1 criteria; IOS was available for all 18 NrP and for 39 GOLD 1 participants cross-sectionally. IOS indicated greater peripheral airway dysfunction in NrP than in GOLD 1, with higher R5-R20 and Fres and more negative X5, despite relatively preserved spirometric indices. In the longitudinal subset (39 GOLD 1; 8 NrP), annual changes in spirometry and IOS exhibited wide variability and did not differ meaningfully between groups. These analyses were limited by small NrP sample size and incomplete IOS availability.</p><p><strong>Conclusion: </strong>PRISm and GOLD 1 demonstrated distinct respiratory-mechanical patterns despite partially overlapping spirometric profiles. IOS identified peripheral airway abnormalities in PRISm that were not evident on spirometry, suggesting potential value for characterizing early or atypical airway dysfunction. However, sample-size limitations and major confounding factors-including age, smoking status, and bronchodilator exposure-preclude causal inference. Findings should be considered descriptive and hypothesis-generating. Larger prospective studies with balanced treatment exposure and comprehensive imaging and lung-volume assessment are needed to clarify the clinical relevance of IOS patterns in PRISm.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"571172"},"PeriodicalIF":3.1,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13006173/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147516247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Burden of Disease Analysis of COPD Attributable to Occupational PGFs in the BRICS Countries, 1990-2021.","authors":"Jia Zeng, Jiao Xie, Shaoqin Huang, Jing Cheng, Qiuxuan Zeng","doi":"10.2147/COPD.S543554","DOIUrl":"https://doi.org/10.2147/COPD.S543554","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death worldwide. The BRICS countries (Brazil, Russia, India, China, and South Africa), which are undergoing rapid industrialization, face significant occupational exposures to particulate matter, gases, and fumes (PGFs)-important risk factors for COPD. This study aims to assess the disease burden of COPD attributable to occupational PGFs in the BRICS countries from 1990 to 2021.</p><p><strong>Methods: </strong>This analysis was based on data from the Global Burden of Disease (GBD) 2021 database, covering the period from 1990 to 2021 for the BRICS countries. The study examined the burden of COPD attributable to occupational PGFs by assessing absolute counts and age-standardized rates (ASRs) for deaths, disability-adjusted life years (DALYs), years lived with disability (YLDs), and years of life lost (YLLs); estimated annual percentage changes (EAPCs) were also calculated for these metrics. Furthermore, a decomposition analysis was performed to identify contributors to changes in COPD burden, stratified by the Sociodemographic Index (SDI). Forecasting of disease burden trends was carried out using exponential smoothing (ES) and autoregressive integrated moving average (ARIMA) models.</p><p><strong>Results: </strong>From 1990 to 2021, the BRICS countries experienced a decline in ASRs for deaths, DALYs, and YLLs from COPD attributable to occupational PGFs. In contrast, the ASR for YLDs showed an increase. However, the absolute numbers of all outcomes rose. This divergence was primarily driven by population growth, which accounted for 85.2% of the rise in DALYs, far outweighing the effects of population aging (8.7%) and changes in age-specific rates (6.1%). By 2021, the absolute burden amounted to 12.60 million DALYs, 585,451 deaths, 10.55 million YLLs, and 2.05 million YLDs. Trend analysis confirmed this pattern, with significant negative estimated annual percentage changes (EAPCs) for DALYs, deaths, and YLLs, but a positive EAPC for YLDs. The burden was highest among men and the elderly (65-79 years) within BRICS, and in low- and middle-income regions globally.</p><p><strong>Conclusion: </strong>Despite declining age-standardized rates, the increasing absolute burden of COPD attributable to occupational PGFs in BRICS countries underscores the urgent need for workplace-focused interventions. Priority should be given to engineering controls, improved ventilation, respiratory protection programs, and occupational health standards in high-risk industries to reduce PGFs exposure at its source.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"543554"},"PeriodicalIF":3.1,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13005215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147500306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of FeNO Decline Rate with Symptom Improvement in COPD: A Real-World Observational Study.","authors":"Boyu Li, Meishan Liu, Honglei Shi, Ying Wang, Xiaoni Meng, Zhuoling An","doi":"10.2147/COPD.S563981","DOIUrl":"https://doi.org/10.2147/COPD.S563981","url":null,"abstract":"<p><strong>Background: </strong>The association between relative changes in fractional exhaled nitric oxide (FeNO) in chronic obstructive pulmonary disease (COPD) with patient-reported symptoms improvements remains uncertain.</p><p><strong>Objective: </strong>To assess the association of the rate of FeNO decline with the achievement of the minimum clinically important difference (MCID) in COPD Assessment Test (CAT) score.</p><p><strong>Methods: </strong>We conducted a single-center, retrospective real-world study involving 111 adults with COPD. Patients were classified into two groups: those with symptom improvement (CAT decline ≥2 points) and those with no improvement (CAT decline <2 points). Logistic regression evaluated associations between FeNO decline rate and CAT MCID, adjusting for clinically relevant covariates. Receiver operating characteristic (ROC) curve analysis estimated the discriminatory performances of it.</p><p><strong>Results: </strong>Of 111 patients, 53 (47.7%) achieved the CAT MCID. Multivariate logistic regression found that the rate of FeNO decline was independently associated with symptom improvement (adjusted OR 2.08, 95% CI 1.01-4.29, <i>P</i>=0.047). Baseline CAT also showed association with symptom improvement (adjusted OR 1.06, 95% CI 1.00-1.12, <i>P</i>=0.034). BMI showed a positive trend but without statistical significance (adjusted OR 1.13, 95% CI 1.00-1.29, <i>P</i>=0.056). AUC of FeNO decline rate, baseline CAT, combined with BMI in discriminating CAT MCID were 0.713 (95% CI 0.617, 0.809).</p><p><strong>Conclusion: </strong>The rate of FeNO decline was significantly associated with clinically meaningful CAT improvement in this study, which indicated dynamic measures of type-2 inflammation can complement blood eosinophil counts to refine phenotyping and inform precision management in COPD.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"563981"},"PeriodicalIF":3.1,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13035481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147595564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reliability of Pulmonary Function Tests in Patients with Chronic Obstructive Pulmonary Disease.","authors":"Fatma Arslan, Elif Şen, Burak Şirin, Nurdan Köktürk, Gaye Ulubay, Selma Aydogan Eroglu, Bilun Gemicioglu, Özlem Sönmez, İrem Şerifoğlu, Asli Gorek Dilektasli, Burcu Öztürk Şahin, İlkay Doğan, Nermin Gürhan, Hakan Günen, Nihal Ensen","doi":"10.2147/COPD.S554115","DOIUrl":"https://doi.org/10.2147/COPD.S554115","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic Obstructive Pulmonary Disease (COPD) is frequently underdiagnosed due to limited use and suboptimal quality of spirometry.</p><p><strong>Methods: </strong>This multicenter, prospective observational study aimed to assess the quality of spirometry tests in COPD patients across six tertiary care centers in Turkey. A total of 560 spirometry tests were independently evaluated by two pulmonologists, and inter-rater reliability was analyzed using Cohen's Kappa.</p><p><strong>Results: </strong>The study included 124 women and 436 men, with a mean age of 65.9±10.2 years. Spirometry patterns were interpreted as obstructive in 79.1% of tests, restrictive in 5.7%, mixed in 2.7%, normal in 6.7%, inconclusive in 5.5%, and as upper airway obstruction in 0.18% of cases (<i>K</i>=0.890). Routine post-bronchodilator testing was performed in 87.14% of the cases, while 12.85% were post-reversibility tests. Graphical data included volume-time curves (88.5%), flow-volume loops (99.6%), and inspiratory limbs (98.7%). Reference values were predominantly based on ECSC (86.4%), followed by GLI (8.9%) and NHANES (0.25%). Mean spirometric values included FEV1 (% predicted) 57.2%, FVC (% predicted) 72.7%, and FEV1/FVC 61.9%. Cough in the first second of FVC was observed in 17 (3%) (<i>K</i>=0.677), variable or insufficient effort 13.4% (<i>K</i>=0.563), mouth leak 1.8% (<i>K</i>=0.305), mouthpiece obstruction 0.5% (<i>K</i>=0.332), rapid expiration 1.8% (<i>K</i>=0.354), increased concavity 83% (<i>K</i>=0.683), and small airway obstruction 87% (<i>K</i>=0.709) were reported by interpreters.</p><p><strong>Conclusion: </strong>Spirometry reports frequently lack key information such as preliminary diagnoses, test indication, technician, and device details. ECSC is the most commonly used reference. Rates of inconclusive and erroneous tests-due to variable or insufficient effort, mouth leak, mouthpiece obstruction, and rapid expiration-are low.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"554115"},"PeriodicalIF":3.1,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13035690/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147595503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Helicobacter pylori</i> Infection and Risk of Chronic Obstructive Pulmonary Disease: A Meta-Analysis and Mendelian Randomization Study.","authors":"Yunpeng Xu, Junfen Li, Cuifang He, Aiju Su, Hongbo Jiang, Boyan Ma, Lei Zhu, Zi Yang, Fanqi Wu, Jian Liu","doi":"10.2147/COPD.S578114","DOIUrl":"https://doi.org/10.2147/COPD.S578114","url":null,"abstract":"<p><strong>Background: </strong><i>Helicobacter pylori</i> (<i>H. pylori</i>) infection and chronic obstructive pulmonary disease (COPD) are both common global public health burdens. Current evidence suggests that <i>H. pylori</i> infection may be associated with the development and progression of COPD.</p><p><strong>Methods: </strong>This study conducted a meta-analysis to systematically evaluate the association between <i>H. pylori</i> infection and COPD risk. Eight Chinese and English databases were searched through September 2025. We then performed two-sample Mendelian randomization (MR) using genetic instruments for <i>H. pylori</i> antibody phenotypes and COPD GWAS summary statistics to test bidirectional causality.</p><p><strong>Results: </strong>A total of 27 studies were included, comprising 7159 participants. Compared with controls, COPD patients had a higher <i>H. pylori</i> positivity rate (RR = 1.43, 95% CI: 1.25-1.60, <i>P</i> < 0.00001). Among COPD patients, <i>H. pylori</i> positivity was associated with poorer lung function (FEV₁/FVC: MD = -6.75, 95% CI: -9.17 to -4.34, <i>P</i> < 0.00001; FEV₁%: MD = -9.34, 95% CI: -12.61 to -6.07, <i>P</i> < 0.00001; FEV₁: MD = -0.16, 95% CI: -0.23 to -0.09, <i>P</i> < 0.00001; FVC%: MD = -5.29, 95% CI: -9.76 to -0.81, <i>P</i> = 0.02; FVC: MD = -0.15, 95% CI: -0.28 to -0.01, <i>P</i> = 0.03). Compared with patients with severe-to-very severe COPD, those with mild-to-moderate COPD had a lower prevalence of <i>H. pylori</i> infection (RR = 0.75, 95% CI: 0.59-0.96; P = 0.02). However, the two-sample MR analysis did not find evidence of a bidirectional causal relationship between <i>H. pylori</i> antibodies and COPD.</p><p><strong>Conclusion: </strong>The study shows that <i>H. pylori</i> infection is more prevalent among patients with COPD and is associated with reduced lung function and greater disease severity, but no genetic evidence of causality was identified. Therefore, based on current evidence, routine <i>H. pylori</i> screening or eradication therapy is not recommended in the general COPD population.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"578114"},"PeriodicalIF":3.1,"publicationDate":"2026-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13003816/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147500305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding Nebulizer Utilization by Patients and Healthcare Providers: A COPD Foundation Nebulizer Consortium Survey Study.","authors":"Kathryn H Melamed, Sergio Martinez, Lisa Cambridge, David C Christiani, Jie Li, Jill Ohar, Rajiv Dhand, M Bradley Drummond, Arzu Ari, Lewis J Radonovich, Donald Tashkin, Matthew Dartt, Arshan Perera, Judy Schloss, Lauren Cochran, David Mannino, Nicholas Locantore, Karmon Johnson, Melinda K Lacy, Ariel Berlinski, Kim Gilchrist, Igor Barjaktarevic","doi":"10.2147/COPD.S552041","DOIUrl":"https://doi.org/10.2147/COPD.S552041","url":null,"abstract":"<p><strong>Rationale: </strong>Inhaled medications are the mainstay of chronic obstructive pulmonary disease (COPD) management. While consensus guidelines for pharmacological management in COPD are well-established, few guidelines exist regarding inhaled medication delivery systems. The COPD Foundation Nebulizer Consortium conducted a cross-sectional survey of patients with COPD and healthcare providers to understand their perceptions and utilization of nebulized medications.</p><p><strong>Methods: </strong>An online survey was conducted from February 7 through April 9, 2024. Patients completed a 42-question survey, including demographic information, tobacco use, symptoms severity, and the role of nebulizers in their treatment. Healthcare providers responded to a 17-question survey about their clinical experience with nebulized medications.</p><p><strong>Results: </strong>We analyzed responses from 347 patients and 39 healthcare providers. Among patients, 76.4% (265/347) were ≥65 years old, 72.0% (250/347) were female, 93.4% (324/347) were white, 90.5% (314/347) had a current or former smoking history, 77.6% (263/339) reported at least one exacerbation in the past year, and 70.8% (240/339) used some form of supplemental oxygen. Nebulizer use was reported by 84.1% (292/347) of patients. Among nebulizer users, 94.5% (276/292) used short-acting while only 22.3% (65/292) used long-acting nebulized medications. Patients reported that hand-held inhaler devices were easier to use (69.8%, 171/245), but nebulized therapy led to better symptom control (64.9%, 159/245) and had lower copays (67.8%, 166/245). Among prescribers surveyed, most (82.1%, 32/39) believed nebulizers were preferable for patients experiencing exacerbations. Impediments to wider use of nebulizers included difficulties with insurance coverage (69.2%, 27/39), cost (53.8%, 21/39), and lack of combination nebulized drugs (46.2%, 18/39). Two-thirds of providers thought that nebulizers were underused.</p><p><strong>Conclusion: </strong>We demonstrate that while patients and providers both perceive nebulizers as preferred in clinical management of COPD, there is discordance between patient and provider perception of nebulizer use on the basis of cost and feasibility of use.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"552041"},"PeriodicalIF":3.1,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13051185/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147635066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond Reported Rates: Detection-Adjusted COPD Prevalence and Underdiagnosis Patterns in Colombia.","authors":"Jorge Ospina, Olga Milena Garcia-Morales, Maria Clara Gaviria","doi":"10.2147/COPD.S554120","DOIUrl":"https://doi.org/10.2147/COPD.S554120","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) is widely underdiagnosed in Colombia, especially in rural departments with limited access to spirometry. We conducted a department-level ecological study using aggregated administrative data from 2020-2023 to generate diagnosis-based COPD prevalence estimates that explicitly account for regional disparities in diagnostic capacity and socioeconomic conditions.</p><p><strong>Methods: </strong>We assembled department-year data from the Individual Registry of Health Services Delivery, national mortality statistics, and the National Quality of Life Survey. A Bayesian generalized additive model with a Gamma family and log link was fitted to a Composite Bias-Correction Multiplier that captured under-ascertainment as a function of spirometry utilization, COPD lethality, outpatient contact rates, multidimensional poverty, household fuel type, and age structure. Posterior estimates of this multiplier were applied to diagnosis-based COPD prevalence in adults aged ≥40 years to obtain detection-adjusted departmental and national estimates. Model performance was summarized using the Bayesian R² (proportion of variability in the multiplier explained by the covariates) and the leave-one-out information criterion (LOOIC) as a measure of expected predictive fit.</p><p><strong>Results: </strong>The model estimated a population-weighted national COPD prevalence of 2.22% (95% credible interval [CrI], 2.21-2.23). Detection-adjusted departmental prevalence ranged from 0.81% in Vichada to 3.50% in Caldas, whereas diagnosis-based prevalence ranged from 0.27% to 2.22%. Spirometry utilization correlated strongly with diagnosis-based prevalence (r = 0.85, p < 0.001), and departments with higher COPD lethality and greater multidimensional poverty required larger adjustment multipliers. The model explained most of the variability in the Composite Bias-Correction Multiplier (Bayesian R² = 0.99) and showed good expected predictive performance (LOOIC = -461.1).</p><p><strong>Conclusion: </strong>COPD prevalence in Colombia shows marked regional heterogeneity driven by demographic risk and uneven diagnostic capacity. Detection-adjusted estimates indicate that the highest burden lies in Andean departments such as Caldas, Boyacá, and Risaralda, while remote Amazon and Orinoco territories experience substantial underdiagnosis. These findings support targeted expansion of spirometry and chronic respiratory care in underserved regions and illustrate how accounting for detection bias can improve chronic disease surveillance in low- and middle-income settings.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"554120"},"PeriodicalIF":3.1,"publicationDate":"2026-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12790769/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147677630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating Multi-Omics Data to Uncover Causal Links Between Mitochondria-Related Genes and Chronic Obstructive Pulmonary Disease: A Mendelian Randomization Study.","authors":"Er Hong, Jia Mao, Zhicheng Ke, Yang Wu","doi":"10.2147/COPD.S553092","DOIUrl":"https://doi.org/10.2147/COPD.S553092","url":null,"abstract":"<p><strong>Background: </strong>As a relatively common respiratory disease, chronic obstructive pulmonary disease (COPD) has a high incidence and mortality rate. Mitochondrial dysfunction has been implicated in COPD pathogenesis, but the causal genes and underlying molecular mechanisms remain unclear.</p><p><strong>Methods: </strong>We performed a summary data-based Mendelian Randomization (SMR) study integrating summary data from genome-wide association studies (GWAS) with blood-based methylation (mQTL), expression (eQTL), and protein quantitative trait loci (pQTL) to identify mitochondrial-related genes causally associated with COPD. Significant findings were validated using two-sample MR, independent lung tissue transcriptomic data (GSE76925), and weighted gene co-expression network analysis (WGCNA) to assess transcriptional consistency and functional convergence.</p><p><strong>Results: </strong>Our integrative SMR and colocalization analyses identified 77 mitochondrial genes linked to COPD risk, including <i>GPX1, TUFM, COQ5, BPHL</i>, and <i>NAGS</i>. A methylation-to-expression regulatory cascade was observed, with hypermethylation at <i>GPX1</i> cg24011261 associated with increased gene expression and higher COPD risk-despite its role as an antioxidant enzyme. Two-sample MR confirmed robust causal effects of <i>GPX1, BPHL, TUFM</i> and <i>COQ5</i> expression on COPD. These findings were replicated in lung tissue: <i>GPX1, COQ5</i>, and <i>TUFM</i> were significantly upregulated in COPD patients (GSE76925). WGCNA revealed that these genes reside within a highly interconnected turquoise module strongly correlated with COPD status (r = 0.43, p < 0.001) and enriched in oxidative phosphorylation and mitochondrial energy metabolism pathways.</p><p><strong>Conclusion: </strong>This study provides systematic genetic and transcriptomic evidence that mitochondrial-related genes, particularly <i>GPX1</i> and <i>TUFM</i>, exert causal effects on COPD risk through regulatory cascades and coordinated network dysregulation. The convergence of genetic, epigenetic, and co-expression evidence underscores mitochondrial dysfunction as a central mechanism in COPD pathogenesis and highlights potential targets for future therapeutic development.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"553092"},"PeriodicalIF":3.1,"publicationDate":"2026-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13003660/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147500396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}